Pain Clinical Trial
Official title:
Pain Coping Strategies in Children With Cerebral Palsy
The aim of the study is to describe pain coping strategies and their evolution in children and adolescent with cerebral palsy.
Towards the end of the 20th century, Lazarus and Folkmann developed the concept that the
individual provides "cognitive and behavioral efforts to control, reduce or tolerate the
internal or external demands that threaten or exceed his or her resources". These cognitive
and behavioral efforts are grouped under the term "coping", which describes a process rather
than personality traits or abilities. Coping is not about controlling stress but about
diminishing, avoiding, tolerating or accepting it.
The pain, "unpleasant sensory and emotional experience related to a bodily injury", aims to
warn the individual that the integrity of his body is threatened, and is thus a real
"stressor". It will lead to the choice of coping strategies, which depends in part on the
characteristics of the individual (his beliefs, stress endurance, anxiety propensity) and
environmental variables (characteristics of the painful situation, social support and
emotional connections, information about the threatening situation). Many studies have shown
that the strategies used to cope with chronic pain in adults and children play a major role
in the adjustment of patients to their pathology, in terms of emotional distress, disability,
and quality of life. The different types of strategies have been widely studied in the
literature in so-called "typical" children. Active strategies classically found in pediatrics
are distraction, cognitive self-instruction, and problem solving. These active strategies are
said to be positive because they have been proven to help children manage pain more
effectively than passive strategies such as catastrophism, helplessness, or seeking social
support, which are dysfunctional because they are not focused on the problem and increase the
negative consequences associated with pain.
This study is about children with cerebral palsy (CP) because the great variability and
complexity of the manifestations of the pathology and the therapeutic treatment make it that
there is a big risk for the child to experience pain, with a prevalence of pain ranging from
60% to 73%, depending on the evaluation methods. Research has done a great deal in recent
years to improve the assessment and management of inborn or induced pain in children with
disabilities, with many validated recommendations, even though this still appears to be a
neglected comorbidity in PC. However, coping strategies of PC children with pain have never
been studied. The purpose of this work is to describe these strategies in PC children and
adolescents, as well as their evolution.
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